Anal Cancer
An anal cancer diagnosis can feel overwhelming and deeply personal. At Charleston Oncology, our team of experienced medical oncologists understands the unique challenges this diagnosis presents — and we are here to guide you through every step with expertise, compassion, and clarity. Anal cancer is a relatively uncommon malignancy, with approximately 10,000 new cases diagnosed in the United States each year. While less common than colorectal cancers, anal cancer is highly treatable when caught early, particularly with access to a specialized oncology team. Charleston Oncology brings the full spectrum of advanced treatment options to patients across the Lowcountry.RSFH Anal
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What to expect from Medical Oncology at Charleston Oncology
What Is Anal Cancer?
Anal cancer forms in the tissues of the anus — the opening at the end of the rectum through which stool leaves the body. The most common type is squamous cell carcinoma, which accounts for the majority of diagnoses. Other less common types include:
- Adenocarcinoma — arising from glandular cells near the anal canal
- Basal cell carcinoma — a skin cancer that can occasionally form near the anal margin
- Melanoma — a rare but aggressive form affecting the anal canal
Risk Factors
Understanding your risk factors is an important part of early detection and prevention. Known risk factors for anal cancer include:
- Human papillomavirus (HPV) infection — present in the majority of anal cancer cases
- HIV infection or a weakened immune system
- History of cervical, vulvar, or vaginal cancer
- Multiple sexual partners or receptive anal intercourse
- Chronic inflammation of the anal region
- Smoking
- Age — most commonly diagnosed in adults over 50
Recognizing the Signs
Anal cancer symptoms can be subtle and are sometimes mistaken for more common conditions such as hemorrhoids or fissures. It is important to discuss any of the following with your physician:
- Rectal bleeding or blood in the stool
- Anal pain, pressure, or a feeling of fullness
- A lump or mass near the anus
- Changes in bowel habits or stool consistency
- Anal itching or discharge
- Swollen lymph nodes in the groin or anal region
Early detection significantly improves treatment outcomes. If you are experiencing any of these symptoms, do not delay seeking evaluation.
Diagnosis at Charleston Oncology
Our oncologists use a comprehensive, evidence-based approach to diagnosis. Depending on your specific situation, workup may include:
- Physical examination and digital rectal exam
- Anoscopy or proctoscopy — direct visualization of the anal canal
- Biopsy — tissue sampling to confirm diagnosis and cancer type
- Imaging — CT scan, MRI, or PET/CT scan to assess staging and potential spread
- HPV testing
Once a diagnosis is confirmed, our team works quickly to determine the stage of your cancer and develop a personalized treatment plan tailored to your individual needs, health status, and goals.
Treatment Options
The primary treatment for most anal cancers is a combination of radiation therapy and chemotherapy — known as chemoradiation — which has proven highly effective and often eliminates the need for surgery. Your Charleston Oncology team will work in close coordination with radiation oncologists and other specialists to deliver a fully integrated care plan.
Chemotherapy
Chemotherapy agents — most commonly mitomycin-C combined with 5-fluorouracil (5-FU) or capecitabine — are used alongside radiation therapy to attack cancer cells and enhance the effectiveness of radiation. In advanced or metastatic disease, systemic chemotherapy regimens may be used alone or in combination with immunotherapy.
Immunotherapy
For patients with advanced or recurrent anal cancer, immunotherapy — specifically immune checkpoint inhibitors — has emerged as an effective treatment option. Charleston Oncology is current with the latest NCCN guidelines and offers access to approved immunotherapy agents for appropriate candidates.
Targeted Therapy
For select patients, targeted molecular therapy may be an option based on specific tumor characteristics identified through molecular profiling.
Surgery
In cases where chemoradiation does not result in complete remission, or for early-stage superficial tumors, surgical intervention may be recommended. In more advanced cases, an abdominoperineal resection (APR) may be necessary. Our team will coordinate with experienced surgical oncologists to ensure seamless care.
Clinical Trials
As a part of the Bon Secours St. Francis Cancer Care network, Charleston Oncology participates in clinical trials that may offer access to novel therapeutic approaches not yet widely available. Ask your oncologist whether a clinical trial may be appropriate for your situation.
Your Multidisciplinary Care Team
Anal cancer treatment at Charleston Oncology involves close collaboration among multiple specialists working on your behalf, including:
- Medical oncologists — coordinating systemic therapy
- Radiation oncologists — designing and delivering radiation treatment
- Surgical oncologists — when surgery is indicated
- Gastroenterologists and colorectal surgeons — for diagnostic procedures
- Oncology social workers — providing emotional support and resource navigation
- Palliative care specialists — supporting your quality of life throughout treatment
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Common Questions
What is the most common treatment for anal cancer, and will I need surgery?
The standard first-line treatment for most anal cancers is concurrent chemoradiation — a combination of chemotherapy and radiation therapy delivered together. This approach is highly effective and, in many cases, achieves a complete response without the need for surgery. Surgery is typically reserved for cases where chemoradiation does not result in full remission, or for very early superficial tumors. Your Charleston Oncology team will discuss whether surgery is a consideration based on your individual diagnosis and staging.
Is anal cancer related to HPV, and can it be prevented?
Yes — the majority of anal cancers are associated with infection by high-risk strains of human papillomavirus (HPV), particularly HPV 16 and 18. HPV vaccination is one of the most effective preventive measures available. The CDC recommends vaccination through age 26 for all individuals, and vaccination may be appropriate for some adults up to age 45. Routine screening for high-risk individuals and avoidance of known risk factors — including smoking — also reduce risk.
Will I need a colostomy bag after anal cancer treatment?
Most patients treated with the standard chemoradiation protocol do not require a permanent colostomy. A temporary colostomy may occasionally be used during treatment to allow the area to heal, but this is not universal. A permanent colostomy is generally only considered when surgery is required due to incomplete response to chemoradiation or disease recurrence. Your oncologist will explain what to expect based on your specific situation.
How is anal cancer different from colorectal cancer?
Anal cancer originates in the tissues of the anus — the opening at the end of the digestive tract — while colorectal cancer begins in the colon or rectum. They are distinct diseases with different causes, risk factors, staging systems, and treatment approaches. Anal cancer is more commonly associated with HPV and is primarily treated with chemoradiation, whereas colorectal cancer treatment more often centers on surgery combined with chemotherapy.
What symptoms should prompt me to see an oncologist about possible anal cancer?
You should consult a physician promptly if you experience rectal bleeding, anal pain or pressure, a lump near the anus, persistent itching or discharge, or unexplained changes in bowel habits. These symptoms can be caused by many benign conditions such as hemorrhoids or fissures, but any symptom that persists for more than a few weeks warrants evaluation. Early-stage anal cancer is highly treatable, so prompt attention to persistent symptoms is always the right course of action.
Schedule a Consultation
If you or a loved one has been diagnosed with anal cancer, or if you have symptoms that concern you, we encourage you to reach out to Charleston Oncology without delay. Our team is ready to provide the expert evaluation and compassionate care you deserve.
Call us at 843-577-6957 or request an appointment online. We serve patients across Charleston, North Charleston, West Ashley, Mount Pleasant, Summerville, and Walterboro.
